Cap on trivialization. Work stoppages delivered in two clicks on the Ameli platform of the Secu, it’s over. In the event of symptomatic infection with the Covid-19 virus, you must, since Wednesday February 1, consult your doctor who will deem it necessary, or not, to stop for a few days depending on your state of health. Like any cold, actually. Three years after the first positive cases identified in France, the government is ending the exceptional measures, which have been renewed many times according to the epidemic waves carried by the Alpha, Beta, Delta or Omicron variants.
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The return to normal first began with the abandonment of wearing a mask in closed places in the spring of 2022. If this barrier gesture was perhaps lacking at work and in public transport during the triple epidemic which shook the health services during the Christmas and New Year holidays, all epidemiological indicators are now green.
With 46.5 contaminations per 100,000 inhabitants in one week, the incidence rate has never been so low since October… 2021! This indicator, which has long served as a compass for health authorities to (re)tighten the screw, is even below the symbolic threshold of 50 new cases per 100,000 which, during the first epidemic waves, sounded the alarm in the corridors of the ministry. of Health as soon as it was crossed. What is more, France has fewer and fewer serious cases. A trend that began in April 2022, and which is confirmed today with less than 900 patients in critical care after contracting Covid-19.
“Very high international herd immunity”
Will the World Health Organization (WHO) sound the end of the pandemic in 2023? Nothing is certain. At a press conference on Friday January 27, its director, Doctor Tedros Adhanom Ghebreyesus, announced the maintenance of the maximum alert level, three years to the day after the institution, based in Geneva, qualified Covid-19 as a public health emergency of international concern. While it “remains very concerned about the situation in many countries”, the WHO emergency committee believes that the “pandemic […] is probably at a transition point”.
And for good reason, if we ignore China – which has suffered a sharp increase in contamination since the end of its ‘zero Covid’ policy – “we have a very high international collective immunity”, affirms to Capital Bruno Lina, virologist and member of the Health Risk Monitoring and Anticipation Committee (Covars, former Scientific Council).
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An immunity, acquired by both vaccination and infection, which opens the way to “more epidemic than pandemic circulation”, he adds. Clearly, Sars-CoV-2 will not disappear but could, like other respiratory viruses, no longer circulate as frequently as known, everywhere in the world and at the same time. But rather at one or more specific periods in the year. Provided of course that no new variant comes to modify the equation.
No new variant in sight
Admittedly, the monitoring of the epidemic is likely to be less precise. Because the contact cases of positive people are no longer approached by Health Insurance to carry out a PCR or antigen test. The volume of tests carried out in medical biology laboratories or in pharmacies should therefore (further) decrease. The Department of Research, Studies, Evaluation and Statistics (DREES) has already indicated that the number of screening tests carried out between January 16 and 22 was at its lowest since… August 2020. 551,200 PCR and antigen tests were made that week. We are far from the tens of millions of tests carried out in January 2022, in the midst of an epidemic wave pushed by Omicron.
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But the health authorities will not navigate on sight, according to Bruno Lina. Virus surveillance is actually going to be standardized and work the same way it does for influenza and other infectious viruses. “Certainly, we are going to get out of a system where people prescribed tests for themselves. But all the surveillance of other infectious diseases is based on five or six networks: sentinel, Oscour for emergencies, hospital intensive care units, the network of hospital laboratories and city laboratories… And also international networks.
As for the risk of being shaken by a new variant, the virologist member of Covars is reassuring. “Today, the Covid-19 viruses circulating are all descendants of Omicron. Admittedly, many media report the progression of certain sub-lineages like BQ1.1 or XBB.1.5… But they are very similar. These viruses hunt each other and are not associated with a clear epidemic recovery”, says Bruno Lina. Clearly, the experts do not see a variant emerging that would completely change the situation. “There are clearly no more differences as important as those which we could know between Alpha and Beta or Delta and Omicron”, he affirms.
Towards an annual vaccination campaign for the most vulnerable?
This lower diversity of variants should therefore, logically, reduce the frequency of epidemic waves. Experts are counting on two scenarios that could be verified this year. “The most likely is that the Covid-19 virus behaves like that of the flu”, advances Bruno Lina. This means that there would be a single epidemic each year, without the phases of reflux and rebounds that mark the year. “Before, we had epidemic waves every four months. There, it is unlikely that a new wave will start in two months”, assumes the virologist.
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A second scenario remains possible, although less favored by experts. “The virus could behave like rhinoviruses and cause two epidemic waves with a kind of common cold, in spring and autumn,” explains Bruno Lina. But what tips the balance in favor of the influenza model is the epidemic capacity of Sars-CoV-2: “The rhinovirus differs from the coronavirus because there are so many different genotypes. There are more than 300. However, we have not identified more than 300 types of Sars-CoV-2, which therefore looks more like influenza viruses”, explains the member of Covars.
Either way, if either scenario occurs, then health authorities may need to revise their vaccine strategy. The Ministry of Health and Prevention is also awaiting the opinion of the High Health Authority (HAS), which must indicate, by the end of February, the course of action to be taken in the medium term. Two hypotheses are on the table: “Either the virus behaves like the flu and the most vulnerable will have to be vaccinated once a year, or it causes two epidemics like rhinoviruses and they will have to be vaccinated twice a year”, launches Bruno Lina . End of suspense in a few weeks.
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